Department of Surgery, Toho University Sakura Medical Center, Chiba, Japan.
Minim Invasive Ther Allied Technol. 2023 Aug;32(4):199-206. doi: 10.1080/13645706.2023.2224437. Epub 2023 Jun 19.
Postoperative gastroesophageal reflux disease (GERD) can be a consequence of laparoscopic sleeve gastrectomy (LSG). Intrathoracic sleeve migration (ITSM) is a factor contributing to its development. This study aimed to investigate whether the occurrence of ITSM can be prevented by applying a polyglycolic acid (PGA) sheet around the His angle.
In this retrospective analysis, 46 consecutive patients who underwent LSG were divided into two groups: Group A - our standard LSG in the first half ( = 23) and Group B - our standard LSG with PGA sheet covering the angle of His in the second half ( = 23). We compared the two groups for one-year postoperative GERD and the incidence of ITSM.
No significant differences were found between the two groups in terms of patient background, operation time, and one-year postoperative total body weight loss, and no adverse effects related to the PGA sheet were observed. Group B had a significantly lower incidence of ITSM than Group A, and the rate of acid-reducing medicine usage was less pronounced in Group B during follow-up ( < .05).
This study suggests that applying a PGA sheet can be safe and effective in reducing postoperative ITSM and preventing exacerbations of postoperative GERD.
腹腔镜袖状胃切除术(LSG)后胃食管反流病(GERD)可能是其术后并发症之一。胸内袖套迁移(ITSM)是其发展的一个因素。本研究旨在探讨在 His 角周围应用聚乙二醇酸(PGA)片是否可以预防 ITSM 的发生。
在这项回顾性分析中,46 例连续接受 LSG 的患者被分为两组:A 组 - 我们在上半年的标准 LSG(n=23)和 B 组 - 我们在下半年的标准 LSG 中 PGA 片覆盖 His 角(n=23)。我们比较了两组患者术后一年的 GERD 和 ITSM 发生率。
两组患者在患者背景、手术时间和术后一年总体重减轻方面无显著差异,且未观察到与 PGA 片相关的不良反应。B 组 ITSM 发生率明显低于 A 组,且在随访期间 B 组使用抑酸药物的比例较低(<.05)。
本研究表明,应用 PGA 片可安全有效地减少术后 ITSM,并预防术后 GERD 的恶化。